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Biomedical subjects

I Ramzy

Publications and source records attributed to I Ramzy.

At least 91 records · Page 5Linked to original sources

Adenovirus-mediated thymidine kinase gene therapy for recurrent ovarian cancer: expression of coxsackie-adenovirus receptor and integrins alphavbeta3 and alphavbeta5.

OBJECTIVE: Ten patients with recurrent ovarian cancer received a combined treatment of optimal tumor debulking, adenovirus-mediated herpes simplex virus thymidine kinase gene therapy (GT), and systemic application of acyclovir or valacyclovir and topotecan. Biopsies were taken at the time of secondary debulking about 1 month after the application of GT and chemotherapy and were analyzed for expression of coxsackie-adenovirus receptor (CAR) and integrins alphavbeta3 and alphavbeta5 with respect to treatment response. METHODS: Treatment modalities and study design have been described recently. Immunohistochemistry was used to visualize expression of CAR and integrins alphavbeta3 and alphavbeta5 in tumor samples taken before and after application of GT. RESULTS: Before GT six of ten patients presented with CAR-positive and four with CAR-negative tumors. After GT all tumors showed CAR expression. Integrin alphavbeta3 was found in all tumors before and after GT. Expression of integrin alphavbeta5 was seen in eight of ten tumor samples before GT and in all samples after GT. CONCLUSION: Despite the importance of CAR and integrin expression for successful adenovirus internalization, other cell surface receptors might be involved in this process. It is too early to decide whether expressions of CAR and integrin alphavbeta3/alphavbeta5 on tumor cells are appropriate additional inclusion criteria for the enrollment of patients in GT trials. Further research is necessary to evaluate the effect of GT plus chemotherapy on CAR and integrin expression.

Adult↗

Fine needle aspiration of pancreatic cystic epithelial neoplasms.

Pancreatic cystic epithelial neoplasms present diagnostic challenges in cytology. An accurate diagnosis is important since the prognosis and treatment may vary. We report the cytologic features in fine needle aspirates of four cases of cystic neoplasms of the pancreas (two micro-cystic adenomas, one mucinous cystic neoplasm and one mucinous cystadenocarcinoma). Smears were evaluated as to their cellularity, content and predominant cell type. Aspirates from the microcystic adenomas yielded hypocellular material with rare strips of cuboidal cells having bland nuclei and pale cytoplasm. No mucinous material was identified in the background, but the cells stained positively with periodic acid-Schiff stain. Smears from the mucinous cystic neoplasm were moderately cellular and contained abundant mucinous material. The columnar epithelial cells were arranged in tight sheets, clusters and strips. Most cells had benign nuclear features with focal mild nuclear atypia. Key cytologic findings noted in the mucinous cystadenocarcinoma were moderate cellularity, loose clusters of cells, single cells, overt malignant nuclear features and occasional signet ring cells. Pancreatic pseudocysts can be distinguished from pancreatic cystic epithelial neoplasms by the predominance of histiocytes and inflammatory cells and absence or paucity of epithelial cells. To differentiate microcystic adenomas from mucinous cystic neoplasms, the above criteria coupled with periodic acid-Schiff and mucin staining should effectively differentiate these diagnostic entities.

Aged↗

Adamantinoma. A case report with aspiration cytology and differential diagnostic and immunohistochemical considerations.

Fine needle aspiration biopsy of bone lesions is routinely used in the metastatic workup of patients with radiographically suspicious areas. However, caution must be used when interpreting smears from aspirates performed on primary bone neoplasms. These tumors are often heterogeneous, and problems with sampling may be encountered. We report a case of a 25-year-old male who presented with a 3-cm lytic lesion in the tibia. A diagnosis of benign fibroosseous lesion was based on the clinical presentation, radiographic appearance and presence of numerous sheets and single cytologically bland spindle cells. Subsequent curettage of the specimen revealed an adamantinoma with a prominent fibrous component. Most of these rare, locally aggressive neoplasms are located in the tibia. They are characterized histologically as having a fibrous background with islands of basaloid, spindle or squamoid cells. Furthermore, a differentiated, regressing variant with an osteofibrous dysplasia-like appearance also exists. Smears consisting primarily of spindle cells or fibrous tissue may lead to an erroneous diagnosis of a fibrohistiocytic neoplasm, fibrous dysplasia, fibrous cortical defect or ossifying fibroma. Pertinent cytomorphologic features should aid in establishing the correct diagnosis of adamantinoma.

Adult↗

Pulmonary paragonimiasis. Report of a case with diagnosis by fine needle aspiration cytology.

We report a case of paragonimiasis in a Nigerian woman evaluated for symptoms of chronic respiratory disease five years after chemotherapy for primary lymphoma of the breast. Fine needle aspiration of one of two fibrocavitary pulmonary lesions yielded thick, brown material in which ova diagnostic of Paragonimus westermani were identified cytologically. This disease is unusual in natives of North America but is seen in travelers and immigrants from Asia, Africa, and South and Central America, where it is endemic. The infection can be fatal, especially if it involves the central nervous system. The clinical differential is broad, but an accurate diagnosis may be made by fine needle aspiration, thus allowing proper treatment.

Adult↗

Immunocytochemical characterization of large-cell carcinomas of the lung. Role, limitations and technical considerations.

To clarify the use of cytologic preparations, particularly those previously stained by the Papanicolaou method, for the immunocytochemical evaluation of large-cell carcinomas (LCCs), 37 cytologic preparations from cases diagnosed as LCC were examined using a battery of immunocytochemical stains for keratin, chromogranin, common leukocyte antigen (CLA) and B72.3. Thirty-two specimens were from the thoracopulmonary region (12 fine needle aspirates of the lung, 7 bronchial brushings, 5 bronchial washings, 2 sputa and 6 pleural fluids); the remaining specimens were fine needle aspirates of 3 lymph nodes, 1 vertebral body and 1 liver. Of the specimens analyzed, 30 of 37 were positive for keratin and 7 of 35 were positive for B72.3 (6 were positive for both). Only 1 of 37 was positive for CLA while none of 37 was positive for chromogranin. Six specimens showed no reaction with either keratin, B72.3 or chromogranin. These results confirm that the majority of LCCs consist of epithelial cells of either a squamous or an adenocarcinomatous type. They also show that immunocytochemistry is a useful diagnostic adjunct that can be applied to cytologic preparations previously stained by the Papanicolaou method; this is important since immunostaining is often considered after undifferentiated malignant cells are encountered in a previously stained preparation. However, a thorough understanding of some technical limitations is critical in the evaluation of the results of this technique when it is applied to cytologic specimens.

Aged↗

Transbronchial fine needle aspiration of the mediastinum. Importance of lymphocytes as an indicator of specimen adequacy.

To determine the effectiveness and accuracy of transbronchial fine needle aspiration of mediastinal masses for the staging of bronchogenic carcinoma, the results and histologic correlations of 97 transbronchial aspirates submitted from 78 patients over a two-year period were reviewed. Malignant cells were present in 25 of 97 aspirates. Of the remaining 75 nonmalignant aspirates, 34 had corresponding mediastinal tissue sections. Review of these 34 aspirates disclosed respiratory epithelial cells without lymphocytes in 20, lymphocytes without respiratory cells in 1 and both cell types in 8. Neither cell type was present in five aspirates. The predictive value of a negative result was 78% for nonmalignant aspirates containing lymphocytes and 36% for nonmalignant aspirates not containing lymphocytes (P less than .05). The presence of lymphocytes in transbronchial needle aspirates of the mediastinum is an essential criterion of specimen adequacy. Negative specimens lacking lymphocytes should be considered unsatisfactory, regardless of the numbers of respiratory epithelial cells present.

Adenocarcinoma↗

Hansen's disease (leprosy). Diagnosis by aspiration biopsy of lymph nodes.

A 61-year-old male native of Mexico presented with generalized enlargement of lymph nodes. Fine needle aspiration (FNA) biopsy established lepromatous leprosy as the cause of the lymphadenopathy. The cytologic findings included abundant, frequently multinucleated histiocytes (globus cells), the cytoplasm of which showed multiple vacuoles; cytoplasmic membrane-bound vacuoles were seen free in the background. The vacuoles contained large numbers of acid-fast bacilli. Globus cells, while characteristic, are not specific for Mycobacterium leprae infection and are seen in certain atypical mycobacterioses in immunodeficient patients. This appears to be the first report of lymphadenopathy due to lepromatous leprosy in which the diagnosis was made by FNA biopsy. The immunologic spectrum of leprosy is correlated with clinical and pathologic findings, and the need to remember infectious processes in evaluating lymphadenopathy and the value of reserving air-dried and alcohol-fixed smears for special stains are emphasized.

Biopsy, Needle↗

Signet-ring cell stromal tumor of ovary cytologic appearances of fine needle aspiration biopsy.

The cytologic appearances of fine needle aspiration biopsy from a benign signet-ring cell tumor of ovarian stroma are presented. The aspirate is characterized by the presence of many cells with large vacuoles in their cytoplasm giving them the signet-ring appearance. The lack of malignant criteria in the nuclei and the failure to demonstrate mucin or lipid by special stains helps to differentiate these cells from other sources of signet-ring cells such as mucinous cystadenomas and cystadenocarcinomas and Krukenberg tumors.

Biopsy, Needle↗

Benign schwannoma: demonstration of Verocay bodies using fine needle aspiration.

The cytologic findings in fine needle aspiration biopsy from case of benign Schwannoma of the vagus nerve are presented. In addition to the presence of individual spindle-shaped neoplastic cells, histiocytes and blood, characteristic Verocay bodies were identified. These showed peripheral arrangement of their nuclei within the cell masses, leaving central areas of fibrillary cytoplasm. The differential diagnosis of this tumor from some of the other neoplasms is discussed.

Biopsy, Needle↗

Prostatic duct carcinoma: exfoliative cytology.

The cytologic findings in voided urine specimens from prostatic duct carcinoma are presented. Neoplastic cells from these unusual tumors were identified as well as the occasional red blood cell and histiocyte. The adenocarcinoma cells features irregular nuclei and their cytoplasm was occupied almost entirely by large secretory vacuoles. The differential diagnosis of this tumor from some other neoplasms and its association with transitional cell carcinoma as well as its histogenesis are discussed.

Adenocarcinoma↗

Chronic eosinophilic pneumonia. Diagnosis by fine needle aspiration.

A case of chronic eosinophilic pneumonia in which the diagnosis was established by fine needle aspiration of the pulmonary lesions is presented. The cytologic findings included the presence of an inflammatory exudate consisting of 40% eosinophils, 25% neutrophils and the remaining cells comprised of lymphocytes, histiocytes, atypical columnar cells and cells probably of pneumocyte type II origin. Fine needle aspiration of pulmonary infiltrates can be quite helpful in confirming the diagnosis of chronic eosinophilic pneumonia and in differentiating it from other similar conditions including malignant lymphomas, if the clinical and radiologic appearances are also taken into consideration.

Adult↗

Fine needle aspiration of ovarian masses. II. Correlative cytologic and histologic study of nonneoplastic cysts and noncelomic epithelial neoplasms.

A wide variety of neoplasms and nonneoplastic cysts involves the ovary. Seventy-seven ovarian masses were aspirated using fine needles. They included 32 nonneoplastic cysts of various types, 29 celomic epithelial neoplasms, 10 germ cell neoplasms and 6 other neoplasms. The study was performed in order to elucidate the cytologic features of aspirates from these lesions and correlate them with the histologic features. Material aspirated from malignant neoplasms resulted in abundantly cellular specimens while aspirates from benign neoplasms and nonneoplastic cysts showed only scanty cells. Follicular cysts and corpus luteum cysts showed similar cell types but with various degrees of cellularity and incidence of cell types. Cysts lined by a single layer of cuboidal cells, such as paraovarian and paratubal cysts, were very similar cytologically. The three types of germ cell neoplasms encountered showed features which were diagnostic of each entity. It was difficult to discriminate between some of the types of the sex cord and mesenchymal neoplasms. Aspiration cytology can achieve a satisfactory classification of ovarian masses. It has a specific role to play especially in young patients, in whom preservation of ovarian function is advisable.

Biopsy, Needle↗

Fine needle aspiration of ovarian masses. I. Correlative cytologic and histologic study of celomic epithelial neoplasms.

The ovary is commonly involved by a wide variety of neoplasms and nonneoplastic masses. Seventy-seven ovarian masses were aspirated using fine needles. They included 29 neoplasms classified as being of celomic epithelial origin. The study was performed in order to elucidate the cytologic features of material aspirated from these neoplasms and to correlate them with the histologic features. As expected, material aspirated from malignant neoplasms was much more cellular than material obtained from benign neoplasms. By studying the background material, nuclear and cytoplasmic features of the epithelial cells, as well as the presence of other structures such as psammoma and hyaline bodies, a fairly specific pattern can be recognized for each neoplasm. Using aspiration cytology, a conclusion can be made regarding the malignant or benign nature as well as the specific type and classification of the ovarian neoplasms. Aspiration cytology, especially with the increased use of laparoscopy, has a specific role to play in the diagnosis of celomic epithelial neoplasms of the ovary. It is a valuable method when preservation of ovarian function or minimizing surgical trauma to the patient is desirable.

Adenocarcinoma↗

Anaplastic sacrococcygeal chordoma. Fine needle aspiration cytologic findings and embryologic considerations.

A case of sacrococcygeal chordoma with anaplastic features is presented. The diagnosis of the anaplastic component was first established by fine needle aspiration (FNA) biopsy, which demonstrated the sarcomatous elements as well as the physaliferous cells characteristic of chordoma. Subsequent histologic examination confirmed these findings. While the FNA cytologic findings of chordoma have been previously reported, this is the first case of an anaplastic chordoma diagnosed by FNA biopsy. The embryologic origin of this unusual tumor and its differential diagnosis are discussed.

Aged↗

Focal adenomatoid hyperplasia of salivary glands. A differential diagnostic problem in fine needle aspiration biopsy.

Adenomatoid hyperplasia of minor salivary glands is an idiopathic lesion usually involving the palate and mimicking a primary salivary gland neoplasm. In particular, the lesions may resemble low-grade mucoepidermoid tumors clinically and by fine needle aspiration (FNA) cytology. An illustrative case is presented, and the nature of this unusual entity is reviewed. Its importance in the differential diagnosis of FNA biopsies of minor salivary gland lesions is also discussed.

Biopsy, Needle↗

Ependymal cyst of the subarachnoid space. Cytologic diagnosis and developmental considerations.

Fluid aspirated from a subarachnoid cystic lesion that covered and compressed part of the left frontal lobe was examined cytologically and compared with histologic sections of the cyst wall. The fluid contained epithelial and histiocytelike cell populations. The epithelial cells were tall columnar, occurring singly or in clusters or sheets. Many cells were ciliated and their cytoplasm showed characteristic refractile granules. The differential diagnosis of this rare type of subarachnoid cyst and the mechanism of the development are discussed. Cytologic evaluation of the fluid of the subarachnoid cysts is potentially a more accurate method of classification of these lesions than is random biopsy of the cyst wall. It is of particular importance in cases with a history of growth, in which the progressive expansion results in attenuation of the diagnostic epithelial lining of the cyst.

Adult↗

Metastatic spindle-cell carcinoma. Cytologic features and differential diagnosis.

Fine needle aspiration biopsies of tumors can yield a variety of spindle cells derived from several types of neoplasms. Among these is a rare lesion known as a "spindle-cell carcinoma" or "pseudosarcoma," which may represent a transformation of a preexisting squamous-cell carcinoma that has been subjected to radiotherapy or solar damage. The cytologic, histologic and ultrastructural features of a case of metastatic spindle-cell carcinoma of the rib subjected to fine needle aspiration are presented, and other spindle-cell tumors that should be considered in the differential diagnosis are discussed.

Biopsy, Needle↗